Friday, October 22, 2010

What is Raynaud's?

When I was in school, my friends called me "dead hands" because they would turn blue with cyanosis. Even stranger was when they would also turn white. Sometimes they would appear red, white and blue - all at the same time! They were numb. I'd thump a finger on the desk and it felt like it was someone else's hand. Raynaud's was the first visually undeniable inclination we had that I was an autoimmunie.

Raynaud's (or Reynaud's) is a condition that may be primary (not associated with other disease, called Raynaud's Disease) or secondary to another disease (then called Raynaud's Phenomenon). In the case of most autoimmunies, their Raynaud's is a result of their autoimmune condition. It is much more frequently found in women than men.

Raynaud's is a condition of the sympathetic nervous system. This is a part of your nervous system which you cannot control. Sweating is a part of the sympathetic nervous system. When you become hot, your brain signals your body to to cool itself by sweating.

Raynaud's is an overreaction of the sympathetic nervous system. A tiny breath of cool air, handling a vibrating tool or steering wheel, or a little stress is all that it takes for the body to assume it's going to die and take precautions to save the most important organs. The blood vessels of the extremities squeeze very tight, resulting in numbness and color change.

Raynaud's may affect any or all of the extremities including fingers and toes, hands and feet, arms and legs, chin, nose and lips, and ears. It is the most common symptom podiatrists encounter. Raynaud's patients are often called 'Frosties'. These patients frequently have other diseases and disorders that involve the abnormal constriction of blood vessels such as Migraine, variant angina and pulmonary hypertension.

There are four phases to a classic Raynaud's attack:

1. Pallor - loss of color. May appear abnormally white because arteries are constricted, blood flow restricted.
2. Cyanosis - area turns blue to purple as tissues become oxygen starved.
3. Rubor - circulation returns and the area turns red. It may also swell.
4. Normalization

Not all four phases are always seen with each attack, or in each person. If a woman with Raynaud's becomes pregnant she may see a decline or elimination of symptoms due to increased blood flow. Raynaud's of the breast in a nursing mother can be extremely painful however.

Raynaud's is usually found bilaterally. Rarely it is unilateral - found on only one side of the body. In either case, there is often a distinct line of color change on the extremity, from white, to blue to red.

Usually Raynaud's is fairly self-limiting. However, it can be severe and attacks long-lasting, resulting in tissue death and the need for amputation. Eventually in even moderate cases, permanent damage can occur in the underlying tissues including skin, muscles, blood vessels, nails.

Although there are medicines that many patients find helpful to control their Raynaud's, the best thing to do is to avoid triggering an attack in the first place.

Next, Raynaud's triggers - a list
Comment by Erin on October 29, 2010 at 10:08pm
Is that where your hands and feet feel really cold and often you cant actually FEEL they are cold? cause my workers say they are cold but they dont feel cold to me i have never had them change colour well not that i know of anyway. Who diagnoses this type of thing a neuro or a rheumatologist?
Comment by debdrake on October 29, 2010 at 10:56pm
The podiatrist is the one that told me I have it. I kept getting sores on my feet. So finally I went to the foot doctor. He looked at my feet and asked if they are usually that cold. They were cold and white at the time. He said the sores were from the feet touching the shoes when there was not enough blood in the feet. Its very painful to touch anything frozen or even very cold for any length of time. I'm good about not letting them get to the blue state.
Comment by Ellen S on October 29, 2010 at 11:32pm
Erin, I think there are different doctors that can diagnose this. I had testing done by a thoracic surgeon. It is more than cold extremities though. The color changes are a hallmark of the disorder. Doctors will tell you - if you have Raynaud's, you KNOW you have it, lol. Makes your hands and feet etc look crazy strange.
Comment by Ellen S on October 29, 2010 at 11:32pm
Deb, Have you ever been evaluated for blood sugar or insulin issues?
Comment by Erin on December 10, 2010 at 10:06pm
well what else would make your feet and hands cold but you cant feel the temperature changes? My toe nails always get affected they always split and im not sure about colour changes ive never noticed but ive dont think ive ever had a dr apart from the podiatrist look at them.
just trying to figure all this out
Comment by Ellen S on December 12, 2010 at 1:15am
What did your podiatrist say Erin?  There can be other circulatory issues that can cause these kinds of issues.  Many things I've found can cause nail trouble - including circulation!  Have you had your thyroid and vitamin levels looked at??

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